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Injury modelling for strategic planning in protecting the national infrastructure from terrorist explosive events
  1. Johno Breeze1,2,
  2. R N Fryer3,
  3. T-T N Nguyen2,
  4. A Ramasamy2,4,
  5. D Pope5 and
  6. S D Masouros2
  1. 1Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
  2. 2Bioengineering, Imperial College London, London, UK
  3. 3Platform Systems, Dstl, Fareham, UK
  4. 4Trauma and Orthopaedics, Milton Keynes Hospital NHS Foundation Trust, Milton Keynes, UK
  5. 5Physical Sciences Department, Defence Science and Technology Laboratory, Salisbury, UK
  1. Correspondence to LtCol Johno Breeze, Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK; editor.bmjmilitary{at}bmj.com

Abstract

Terrorist events in the form of explosive devices have occurred and remain a threat currently to the population and the infrastructure of many nations worldwide. Injuries occur from a combination of a blast wave, energised fragments, blunt trauma and burns. The relative preponderance of each injury mechanism is dependent on the type of device, distance to targets, population density and the surrounding environment, such as an enclosed space, to name but a few. One method of primary prevention of such injuries is by modification of the environment in which the explosion occurs, such as modifying population density and the design of enclosed spaces. The Human Injury Predictor (HIP) tool is a computational model which was developed to predict the pattern of injuries following an explosion with the goal to inform national injury prevention strategies from terrorist attacks. HIP currently uses algorithms to predict the effects from primary and secondary blast and allows the geometry of buildings to be incorporated. It has been validated using clinical data from the ‘7/7’ terrorist attacks in London and the 2017 Manchester Arena terrorist event. Although the tool can be used readily, it will benefit from further development to refine injury representation, validate injury scoring and enable the prediction of triage states. The tool can assist both in the design of future buildings and methods of transport, as well as the situation of critical emergency services required in the response following a terrorist explosive event. The aim of this paper is to describe the HIP tool in its current version and provide a roadmap for optimising its utility in the future for the protection of national infrastructure and the population.

  • trauma management
  • oral & maxillofacial surgery
  • preventive medicine

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study. This is a review article.

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Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study. This is a review article.

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Footnotes

  • Twitter @icsmas

  • Contributors JB: review, drafting, final approval of the manuscript, overall responsibility. RNF, T-TNN, AR, DP, SDM: review, drafting, final approval of the manuscript.

  • Funding This work received financial support from the Royal British Legion.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.